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84 Cards in this Set

  • Front
  • Back
What is the pedicle?
The base of the flap that contains the blood supply
What is a local flap?
A flap that shares a side with the defect
What is a regional flap?
the flap is near, but not immediately adjacent to the defect
What is a distant flap?
the flap is not near the defect
What is a free flap?
Free tissue transfer
What is the best method of flap assessment?
Clinical evaluation of temperature, color, cap refill, point bleeding and firmness
What temperature should the flap be?
body temperature
What should capillary refill time of the flap be?
2 seconds
What is pin-point bleeding?
Upon introduction of a fine gauge needle there should be bleeding and the blood should be red, not purple-blue
What are signs of insufficient areterial supply to a flap?
Cool, pallor (white), cap refill >2 seconds, slow or absent point bleeding, soft
Describe the firmness of a healthy flap.
soft, but with some appreciable turgor
What are signs of insufficient venous return?
warmer than expected, blue to purple hue, cap refill <2 seconds, brisk point bleeding with dark blood, tense and swollen
What are some factors leading to vascular compromise of the flap?
tight dressings, tight sutures, pressure from positioning, hematoma, kinking of flap or pedicle, cool ambient room temperature, nicotine, caffeine or other vasoconstrictors
What is the Crane principle?
A pedicled flap is used to lift, transport and deposit subcutaneous tissue from one place to another. After 10-21 days, the top portion of the flap is returned to the donor site
What is an angiosome?
A composite unit of skin and underlying tissue supplied by a source vessel.
What is delay phenomenon?
A flap is partially elevated and reset in a separate procedure before definitive flap elevation and transfer
What are the benefits of delay?
Changes in sympathetic tone, increased number of vessels in the flap (angiogenesis), dilation of previously present choke vessels, metabolic changes in the flap - increasing tolerance
What is the time recommended between delay procedures?
Usually 7-14 days
What are the indications for a cutaneous flap?
reconstruction of a local defect with similar, adjacent tissue, need for full-thickness tissue to cover relatively less vascular tissue (bone or tendon without periosteum/paratenon intact)
What is the blood supply to the skin?
direct cutaneous arteries, fasciocutaneous arteries and musculocutaneous arteries
A groin flap is what type of flap?
A
A reverse superficial sural flap is what type of flap?
A
A radial forearm flap is what type of flap?
B
A scapular/parascapular flap is what type of flap?
B
A temporoparietal fascia flap is what type of flap?
A
A lateral arm flap is what type of flap?
B
A posterior interosseus flap is what type of flap?
B
A paramedian forehead flap is what type of flap?
C
A groin flap is used to correct what anatomic defects?
abdominal wall, perineum, hand, forearm
A reverse superficial sural flap is used to correct what anatomic defects?
foot and heel
A radial forearm flap is used to correct what anatomic defects?
anterior, posterior forearm, elbow, upper arm
A scapulr/parascapular flap is used to correct what anatomic defects?
shouler, axilla, thoracic wall
A temporoparietal fascia flap is used to correct what anatomic defects?
Ear, ipsilateral face, FOM
A lateral arm flap is used to correct what anatomic defects?
anterior,posterior shoulder
A posterior interosseus flap is used to correct what anatomic defects?
elbow, antecubital fossa, proximal volar forearm
A paramedian forehead flap flap is used to correct what anatomic defects?
Nose, midface, forehead
What is the blood supply to a groin flap?
superficial circumflex iliac
What is the blood supply to a reverse superficial sural flap?
median superficial sural
What is the blood supply to a radial forearm flap?
radial
What is the blood supply to a scapular/parascapular flap?
circumflex scapular (transverse and descending) branches
What is the blood supply to a temporoparietal fascia flap?
superficial temporal
What is the blood supply to a lateral arm flap?
posterior radial collateral
What is the blood supply to a posterior interosseus flap?
posterior interosseus
What is the blood supply to a paramedian forehead flap?
supratrochlear, supraorbital
What is a type I flap?
one vascular pedicle
What is a type II flap?
One dominant pedicle and one or more minor pedicles
What is a type III flap?
2 dominant pedicles
What is a type IV flap?
segmental pedicles
What is a type V flap?
one dominant pedicle and several segmental smaller pedicles
What is the difference between a type II and a type V flap
In a type V, the flap can survive on the minor pedicles alone
Give an example of a type I flap.
Gastrocnemius, tnesor fascia lata
Give an example of a type II flap.
Biceps femoris, rectus femoris, soleus, gracilis
Give an example of a type III flap.
gluteus maximus, rectus abdominis, serratus anterior
Give an example of a type IV flap.
extensor hallucis longus sartorius, tibialis anterior
Give an example of a type V flap.
Latissimus dorsi, pectoralis major
What type of flap is a gastrocnemius flap?
type I
What type of flap is a soleus flap?
Type II
What type of flap is a latissimus dorsi flap?
Type V
What type of flap is a pectoralis major flap?
Type V
What type of flap is a rectus abdominus flap?
Type III
What type of flap is a gluteus maximus flap?
Type III
What type of flap is a tensor fascia lata flap?
Type I
What type of flap is a gracilis flap?
Type II
What is the blood supply for a gastrocnemius flap?
Sural
What is the blood supply for a soleus flap?
popliteal, posterior tibial, peroneal
What is the blood supply for a latissimus dorsi flap?
thoracodorsal
What is the blood supply for a pectoralis major flap?
throracoacromial
What is the blood supply for a rectus abdominis flap?
superior and deep inferior epigastric
What is the blood supply for a gluteus maximus flap?
superior and inferior gluteal
What is the blood supply for a tensor fascia lata flap?
lateral circumflex femoral (ascending branch)
What is the blood supply for a gracilis flap?
medial circumflex femoral
A gastrocnemius flap is used for what anatomic areas?
suprapatellar, knee, upper one-third tibia
A soleus flap is used for what anatomic areas?
middle, lower one-third of leg
A latissimus dorsi flap is used for what anatomic areas?
neck, occiput, parietal skull, face, chest, abdomen
A pectoralis major flap is used for what anatomic areas?
face to orbital rim, neck, chest, upper arm
A rectus abdominis flap is used for what anatomic areas?
anterior thorax, groin, perinuem, inferior trunk
A gluteus maximus flap is used for what anatomic areas?
sacrum, ipsilateral ischium
A tensor fascia lata flap is used for what anatomic areas?
lower abdominal wall, groin, perineum
A gracilis flap is used for what anatomic areas?
groin, perineum, vagina, anus, ischium
Which of the following muscles is included in a facial artery musculomucosal flap?
Buccinator
Which of the following vessels is included in a submental flap?
submental artery and vein
which artiery supplies the myocutaneous flap?
facial
what is the major blood supply to the pec major flap?
thoracoacromial artery
what is the blood supply of the superficial inferior epigastric artery (SIEA) flap?
superficial inferior epigastric (SIE) artery